Kidney Week

Abstract: SA-PO0674

Hypertensive Disorders of Pregnancy and Two-Year Kidney Outcomes in Extremely Premature Neonates

Session Information

• Pediatric Nephrology: Transplantation, Hypertension, AKI, Genetics, and Developmental Diseases
  November 08, 2025 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1900 Pediatric Nephrology

Authors

• Defreitas, Marissa J., University of Miami Miller School of Medicine, Miami, Florida, United States

Marissa J. Defreitas, MD

• Griffin, Russell, University of Alabama at Birmingham Health System Authority, Birmingham, Alabama, United States

Russell Griffin

• Sanderson, Keia, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States

Keia Sanderson, MD, MS

• Young, Karen C., University of Miami Miller School of Medicine, Miami, Florida, United States

Karen C. Young, MD, MS

• Isaac, Jaya, Albert Einstein College of Medicine, New York, New York, United States

Jaya Isaac, MD

• Reidy, Kimberly J., Albert Einstein College of Medicine, New York, New York, United States

Kimberly J. Reidy, MD

• Nada, Arwa, Loma Linda University, Loma Linda, California, United States

Arwa Nada, MD, MS, MSc

• Charlton, Jennifer R., University of Virginia School of Medicine, Charlottesville, Virginia, United States

Jennifer R. Charlton, MD, MS

• Jetton, Jennifer G., Medical College of Wisconsin, Milwaukee, Wisconsin, United States

Jennifer G. Jetton, MD

• Kent, Alison, University of Rochester, Rochester, New York, United States

Alison Kent, MD, MBBS

• Guillet, Ronnie, University of Rochester, Rochester, New York, United States

Ronnie Guillet, MD, PhD

• Askenazi, David J., University of Alabama at Birmingham Health System Authority, Birmingham, Alabama, United States

David J. Askenazi, MD, MS, FASN

• Abitbol, Carolyn L., University of Miami Miller School of Medicine, Miami, Florida, United States

Carolyn L. Abitbol, MD

Background

Hypertensive disorders of pregnancy (HDP) have been linked to poor cardiovascular profiles in mother and offspring. In a secondary analysis of the Preterm Epo Neuroprotection Trial (PENUT), 18% of extremely low gestational age neonates (ELGAN) had chronic kidney disease (CKD) at 2 years. Our objective was to evaluate the impact of HDP among ELGAN on kidney function at 2 years of age.

Methods

This is a secondary analysis of the PENUT trial, including neonates <28 weeks’ gestation. The primary outcome was eGFR<90 ml/min/1.73 m² (CKD), albuminuria, and either systolic or diastolic blood pressure (BP) ≥90^th percentile at 2 years. Neonatal and maternal characteristics were compared among HDP and no HDP groups using a Pearson χ² test and Students t-test. A generalized estimating equation (GEE) logistic regression was used to account for variations between centers and determine odds ratios (OR) and 95% confidence intervals (95% CI).

Results

Exposure to HDP was noted in 190/923 (21%) neonates, with pre-eclampsia being the most common (Table 1). Neonatal exposure to any HDP carried a increased adjusted odds of CKD (aOR=1.99 (1.0-3.0)) without significant differences in albuminuria or elevated BP. When analyzed by type of HDP exposure, only pre-eclampsia had a statistically significant adjusted odds of CKD (aOR=2.5 (1.7-3.7)) [Table 2].

Conclusion

Exposure to HDP was prevalent among ELGAN. Pre-eclampsia exposure was associated with 2.5 times increased odds of early onset CKD for offspring. Understanding the mechanisms that drive programming of cardio-renal function in offspring exposed to HDP is crucial for NICU follow up and risk stratification.

Funding

• Private Foundation Support

Digital Object Identifier (DOI)

• doi: 10.1681/ASN.2025arntr63p